Saturday, May 6, 2017

Health Insurance Before Obamacare Came Along

"...there is a reasonably good chance that the insurance company would be successful in denying coverage for treatment of your brain tumor under the pre-existing condition exclusion because the condition first manifested itself in the twelve months immediately preceding the effective date of your coverage."

"Insurance that covers the full cost of pre-existing medical conditions is available but is usually not a financially viable option for individuals who purchase their own coverage... There may be a waiting period, a high deductible, or a high premium cost that is either unmanageable or may outweigh the likely policy benefits over the short term... The best immediate options are to use a lower cost insurance for protection other than the pre-existing medical condition and then manage the immediate medical costs outside of an insurance plan"

"A limited form of cancellation can occur involving reduction or elimination of health insurance benefits. Other than a requirement of reasonable notice, insurers and plans may reduce or eliminate benefits, unless the contract or health service plan prohibits it or limits it."

"A surprising number of patients have been in the middle of costly treatment for a serious disease only to have their policies canceled, sometimes even retroactively, and found themselves responsible for astronomical bills. It’s called rescission.... “Preapproval is often what triggers the rescission review,” says Shernoff. “If it’s for hip surgery, that’s an expensive item that they’ll look at and see if you’re a candidate for rescission."

I went on that link here's what I came up with. I used Lehigh County as my area. Under one scenario I used a 30 year old couple with 2 kids having an income of $40,000. Obamacare would subsidize whatever plan I picked with $742 a month. I ran the same scenario without the kids. The subsidy in this case was $628 a month.

Further Info

No wonder Republicans are having such a tough time coming up with a better plan. Obamacare coverage is compatible in costs and deductibles with those you find on the open market. The thing that's makes it so much better there are these subsidies enabling people to afford coverage.

The only argument for eliminating Obamacare are the costs to government--not the policy holders as they'd have you believe. Let's have a look at that.

According to the "Committee For a responsible Federal Budget" (10/19/2016)--"By FY 2026, the latest year that the Congressional Budget Office (CBO) makes projections for specific programs, Obamacare would still be sixth at $252 billion, behind Social Security ($1.6 trillion), Medicare ($1.1 trillion), defense ($719 billion), interest ($712 billion), and non-ACA Medicaid ($477 billion). Thus, over the next decade, Obamacare will fall further behind the fifth largest program both in dollar terms and, to a lesser extent, as a percent of Gross Domestic Product (GDP)."

The thing to keep in mind the budgeted amount is covered by premiums, higher taxes on those earning above $200,000 and penalties on those refusing to buy insurance for themselves.

How much you say will it cost to eliminate Obamacare completely? Well according to CNN Money--"Fully repealing Obamacare will cost $350 billion over the next 10 years. Obamacare was carefully crafted in 2010 so that it didn't add to the federal deficit -- in fact, it boosted revenues slightly. The law affects the federal budget in three ways: coverage provisions, taxes and fees, and Medicare components."

Talking Points

(1) If conservatives in congress didn't previously mess with the plan undermining some of it's provisions it would be in better shape.

(2) As you can see from the actual facts Obamacare is not bankrupting the government. In fact it does the opposite. It nearly (if not all) pays for itself.

(3) Opponents point out how high the deductibles are. I provided one link showing they are just as high as those currently in the private sector. I urge readers to do similar research. They will find the same thing I'm certain.

(4) Some miscellaneous downsides in changing Obamacare. Lifetime coverage caps could return. Preexisting conditions could be treated the way they were before Obamacare making them highly unaffordable. Many plans employers were required to provide will cease to exist.

(5) Recall the good old days before Obamacare was enacted on March 23, 2010? Bet everyone has a tale of woe.

Some Alternatives

(1) Expand current Medicare.
(2) Tweak the shortcomings in the current plan.
(3) Force the Congress members to take the same plan they wanna give us.

Final Thoughts

Market competition is a fantasy. Prior to Obamacare nearly every company followed the same policies and costs. If anyone thinks it will be different this time around they're going to be extremely disappointed. Obamacare has it's problems. The alternatives will be far worse.

For every dollar not budgeted for Obamacare each will be shifted somewhere else. Everyone should think long and hard how those redistributions will affect each of us in some way.

Republican Rep. Raul Labrador (Idaho) at a town hall (05/05/2017)

The hell they don't. Take for example someone undergoing cancer treatment. No drug company or hospital is going to give away $35,000-$100,000 a month treatments and services.. PERIOD!

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